Liraglutide Treatment Efficacy Of Early Type 2 Diabetic Nephropathy And Its Mechanism Analysis

Objective:To explore the effect and mechanism of early analysis of liraglutide treatment of type 2 diabetic nephropathy.Methods: The clinical research method of random, open, parallel controlled,selected from 2012 December to 2014 June in the Second Affiliated Hospital of Dalian Medical University, Department of Endocrinology outpatient or inpatient treatment in patients with early type 2 diabetic nephropathy in 26 cases, 26 cases were in accordance with the ratio of 1:1 were randomly divided into 13 cases of liraglutide group, n 13 cases of insulin group. Liraru Liraru group by peptide peptide combined with olmesartan, insulin detemir group adopted the losartan treatment of insulin detemir combined with subcutaneous injection of glucose austria. Between the two groups before treatment Cys C, UACR, UAE, BMI showed no significant difference. During the period of treatment was adjusted according to blood glucose levels insulin dosage, 1month follow-up, adverse reactions were recorded at the same time during the treatment,treatment for 6 months. Detection of serum cystatin C in patients before and after treatment(Cys C), random urine albumin to creatinine ratio(UACR), 24 hour urinary albumin excretion rate(UAE) and body mass index(BMI) changes. Comparison of the two groups after 6 months of treatment indicators to improve the amplitude.Results:1. Liraglutide group 6 months after treatment Cys C, UACR, UAE were obviously improved, Cys C fell by an average 2.70±0.38 mg/L, UACR dropped by an average of 10.05±4.75 mg/g, UAE dropped by an average of 85.61±12.85mg/24 h,before and after the differences were statistically significant(P<0.05),indicates that theapplication of liraglutide combined olmesartan treatment, patients with renal function improved significantly.2. Insulin detemir group 6 months after treatment CysC, UACR, UAE were improved, the average decline in Cys C 2.03±0.23 mg/L, UACR dropped by an average of 2.06±3 mg/g, UAE dropped by an average of 67.53±14.30 mg/24 h, before and after the differences were statistically significant(P<0.05),suggest that the renal function of patients can improve the treatment with insulin detemir combined olmesartan hypoglycemic, hypotensive after.3. 6 months after treatment in group CysC, UACR, Liraru peptide UAE to improve the amplitude is greater than the insulin detemir group, the difference was statistically significant(P <0.05).4、Liraglutide group 6 months after treatment BMI decreased by 2.02±0.36kg/m2,and the differences were statistically significant(P<0.05), but the insulin detemir group after treatment for 6 months, the average increase of BMI 0.03±0.10kg/m2, there was no significant difference(P>0.05). That can make the liraglutide significantly decreased body weight, while insulin detemir had no obvious changes on body weight, that liraglutide in weight loss group was significantly better than that of insulin detemir.Conclusion:1. Liraglutide or insulin detemir combined with ARB class of antihypertensive drugs can reduce Cys C, UACR, UAE levels, but the application of Liraglutide group improved significantly greater effect than insulin detemir, prompting Liraglutide potentially reduce urinary albumin, improve the kidney function.2. Obese patients with early type 2 diabetic nephropathy(DN) patients using liraglutide in weight loss was significantly better than insulin detemir group.